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In these spaces, copy the corresponding Information from Section A. I For SECTION D -SURVEYOR, ENGINEER, OR Copy both sides o1 this Elevation Certillcate for (1) community official, (2) Insurance agenticompany, and (3) building owner. f'RA�w� Ht5 XPONA.tCAAS00 wifl//YBA4`YAaIE7Aw- wrga Mess!Sntz66,v- brc I IUN t - rsuaorNO bt-evATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFEI For Zones AO and A (without SFE), complete Items E1 -EB. If the Certificate Is Intended to support a LOMA or LOMR-F request complete Sections A. B. and C. For hens E7 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation Information ler the following and check the appropriate loxes to show whether the elevation is above or below Ore highest adjacent grade (FLOG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement crawl space, or enclosure) Is _ _ ❑ feel ❑ meters❑above or ® below the WIG. b) Top of bottom floor (Including basement crawl space, or enclosure) b _ _ ❑ feet ❑ meters ❑above or below this LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided In Sectl4D.A Items s qr4lor 9 (sees 8 of InsWw clions), the next higher floor (elevation C2b in the diagrams) of the building is _ ❑ feet (-J meters above or Ubelow the NAG. . E3. Attatlsd garage (top of slab) is _ C]feet ❑ melere ❑ above or ❑ below the NAG. E4. Top of platform of machinery and/or equipment servicing the building Is _ ❑ fast ❑ meters ❑ above or ❑ below the HAG. ES. Zone AO only If no flood depth number Is available. Is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information M Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -Issued or community -Issued BFE) or Zone AO must sign here. The statements in Sections A, B. and E era correct to the frost of my knowledge. Property Owners or Owner's Authorized Representative's Name state ur tzce Signature Date Telephone Comments ❑ Check here If enechmenta SECTION G -COMMUNITY INFORMATION (OPTIONAL) and G of this Elevation Certificate. Complete the applicable Item(s) andsign below. Check the measurement used in Items Gil. and G9. G1. ❑ The Information In Section C was taken from other documentation that hes been signed and sealed by a licensed surveyor, engineer, or architect who Is authorized by law to certify elevation information (Indicate the source and dale of the elevation data In the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or cwnmunilyassued BFE) or Zone AO. G3. ❑ The. following Information (Items G4. -G9.) is provided for community floodplain management purposes. G4. Permit Number G3.. Date Permit Issued Gil. Date Certificate Of Compsance/Oocupanry Issued G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement Gil. Elevation of as -built lowest floor (including basement) of the building: []feet ❑ metere (PR) Datum G9. BFE or (in Zone AO) depthflo at build g sip: E] feet ❑ meters (PR) Datum Ve°��pammeni oPublic Workzr—'— Loca101fiOal'sName Engineering Vowslon has review nue Telephone Signature I n' does riot recClTlmared Date 81 all